This op-ed by Mary Ann Peters was published by .
The World Health Organization and the National Institutes of Health recently announced that new treatments appear to sharply increase the survival rate for people who have contracted Ebola. The tests were conducted in the Democratic Republic of the Congo, where an outbreak of this highly contagious disease has already cost 2,000 lives.
But medical progress—as encouraging as it is — alone will not defeat Ebola. To beat this disease, medical practitioners need to be able to reach the at-risk people where they live. And in northeastern DRC, those people are living in a war zone. Unless we prioritize peace, we will not reap the full benefit of scientific breakthroughs like the new treatments for Ebola.
The conflict in northeastern DRC has been going on for decades, bringing suffering, economic devastation and death as all wars do. According to a recent report from the Kivu Security Tracker, 1,900 civilians were killed by armed groups in North and South Kivu provinces in the 24 months ending this June. In the year since the outbreak began, around 2,700 cases of Ebola were identified in North Kivu and Ituri provinces and cases have recently been identified in South Kivu. It is no coincidence that Ebola is flourishing amidst the violence and instability that have plagued this region. And violence and instability in northeastern DRC create conditions for the spread of the disease into neighboring Uganda and Rwanda.
Interventions to end the violence, including the work of the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), have not succeeded in restoring peace to the region. Armed groups have burned down clinics and attacked health workers who are trying to trace people who may be carrying the disease. Militia leaders deny health workers access to regions under their control, even though the militias and their supporters would benefit along with the local populations. In these circumstances, people in need of treatment are afraid to travel, supplies cannot get where they need to go and basic precautions against the disease are overlooked.
Lack of trust in outsiders further complicates efforts to introduce effective treatments and sanitary procedures to unstable or remote areas. In Liberia during the 2014 Ebola outbreak, Â鶹´«Ã½ was able to bridge this trust gap by empowering traditional chiefs and female community leaders to explain and endorse the precautions people needed to take to avoid contracting Ebola. In contrast to the situation in the DRC, Liberia's terrible civil war ended in 2003, opening access to populations at risk for Ebola.
Sadly, the DRC is not the only place where persistent and brutal conflicts hobble campaigns to fight epidemics, eliminate disease and deliver basic health care. In parts of Mali where jihadist militias operate, courageous health care workers look for breaks in the fighting to travel to conflict-isolated villages to dispense basic care and prevent disease. In South Sudan, where a civil war broke out in 2013, children as young as 4 are at risk of losing their sight forever to trachoma, a preventable, treatable disease.
If we are to defeat Ebola and other diseases that threaten global health security, we must take steps to resolve the conflicts that create a favorable environment for the spread of disease. The global public health community that includes Â鶹´«Ã½ is acutely aware of the toll conflict takes on global health. There are many global health heroes who endure danger and hardship to treat vulnerable populations and combat infectious diseases. But in conflict zones the microbes will always have the advantage because they are able to reach people in places health workers cannot go.
To strengthen global health security, we need to get serious about ending conflicts and building peace. We need to allocate meaningful resources to identifying and preventing conflict — because an ounce of prevention is worth much more than a pound of cure. We must address the root causes of the persistent conflicts of this century, like those in the DRC, South Sudan and Mali, with ideas, funding and political will. In the short term, we need to find ways to provide greater security to health workers who risk their lives in conflict zones.
Investing in peace as part of a global health security strategy will complement investments in research and help ensure a healthier and safer world for all.
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